P ubertas adalah masa transisi dari masa anak ke masa dewasa, ditandai dengan munculnya tanda-tanda seksual sekunder dan kemampuan bereproduksi. Pubertas terjadi sebagai akibat dari peningkatan sekresi gonadotropin releasing hormone (GnRH) dari hipotalamus dan diikuti oleh sekuen perubahan sistem endokrin yang komplek serta timbulnya sistem umpan balik negatif dan positif. Sekuen ini akan diikuti oleh tanda seks sekunder, pacu tumbuh, dan kesiapan untuk bereproduksi.1-3 Di negara berkembang masih didapatkan kecenderungan penurunan usia awitan pubertas, yang mungkin disebabkan oleh perubahan standar kehidupan. Selain itu masih terdapat perbedaan status sosial ekonomi dan gaya hidup di pedesaan dan perkotaan, sehingga menyebabkan terjadinya perbedaan usia awitan
Introduction Under 5 years is a critical period for child growth,when growth faltering often occurs. Periodical growth monitoringand nutritional counseling can detect growth faltering earlier, de-termine the cause, and find alternatives to solve such problems.Objective To determine the benefit of nutritional counseling onknowledge, attitude, practice of mothers, and child growth.Methods A randomized controlled trial was conducted inSendangguwo, Semarang on 143 children of the treatment groupand 135 children of the control group. Nutritional counseling wasgiven to mothers in the treatment group by trained health volun-teers. Changes of weight for age Z-score (WAZ), height for age Z-score (HAZ), and weight for height Z-score (WHZ) were analyzedrepeatedly by using ANOVA. The differences of ΔWAZ, ΔHAZ, andΔWHZ between groups were compared by student t-test. GEE (gen-eralized estimating equation) analysis was used to analyze theeffect of confounding variables on the changes of WAZ.Results After 6 months of counseling, knowledge, attitude, andpractice of nutrition in the treatment group significantly increasedcompared to that of the control group (P<0.001). The WAZ, HAZ,and WHZ curves in the control group decreased. However, in thetreatment group, WHZ increased and there was stabilization ofWAZ. At the end of the study, treatment group had significantlyimproved their WAZ (P<0.001), HAZ (P=0.004), and WHZ(P<0.001) compared to that of the control group.Conclusion Nutritional counseling can improve knowledge, atti-tude, and practice of mothers, and has beneficial effects on childgrowth by WAZ, HAZ, and WHZ
Latar Belakang : Paparan sinar matahari pada kulit merupakan cara terbaik untuk sintesis vitamin D. Kadar vitamin D yang adekuat dalam tubuh merupakan proteksi terhadap berbagai penyakit seperti penyakit degeneratif, kanker dan juga infeksi saluran napas. Beberapa penelitian menghubungkan kadar vitamin D yang rendah dengan morbiditas dan mortalitas COVID-19. Hal ini menyebabkan fenomena baru pada masyarakat yaitu kebiasaan berjemur. Tujuan : Artikel ini akan membahas tentang metabolisme vitamin D, peran sinar matahari dalam mengaktifkan vitamin D di dalam tubuh, dan peran vitamin D dalam berbagai penyakit, khususnya mekanisme imunitas untuk COVID-19. Diskusi : Vitamin D meningkatkan kekebalan alami seluler terutama dengan cara menginduksi peptida antimikroba, yang meliputi cathelicidin, LL-37, 1,25-dihdroxyvitamin D dan defensins. Selain itu vitamin D akan meningkatkan sekresi hidrogen peroksida pada sel monosit. Pemberian vitamin D dosis tinggi sebanyak 10.000 IU/hari selama beberapa minggu dilanjutkan 5000 IU/hari bermanfaat untuk mencegah COVID-19, walaupun hasilnya masih memerlukan penelitian lebih lanjut. Absorpsi sinar matahari ke dalam tubuh manusia dipengaruhi oleh warna kulit, penggunaan bahan pakaian dan tabir surya , dan luas pajanan. Paparan sinar matahari sebesar satu Minimal Erythemal Dose (MED) pada orang dewasa dapat meningkatkan konsentrasi vitamin D setara dengan suplementasi 10.000 – 25.000 IU. Penelitian pada bayi yang diberi paparan 3 kali seminggu @ 5 menit pada jam 10.00-14.00, dengan paparan 50% area tubuh selama 2 bulan, mendapatkan kenaikan 25(OH)D sebesar 8,9 ng/mL. Simpulan : Vitamin D yang diaktifkan oleh paparan sinar matahari sangat bermanfaat sebagai proteksi berbagai penyakit termasuk juga pada COVID-19, walaupun efektifitasnya masih memerlukan penelitian lebih lanjut. Kata Kunci : COVID-19, vitamin D, paparan sinar matahari Background : The exposured of sunlight on the skin is the best way for vitamin D synthesis. Adequate vitamin D levels are protection against various diseases such as degenerative diseases, cancer and also respiratory infections. Several studies have linked between low vitamin D levels with COVID-19 morbidity and mortality. This causes a new phenomenon in the community, namely sunbathing. Purpose : This review rearticle will discuss about vitamin D metabolism, the role of sunlight in activating vitamin D in the body, and the role of vitamin D in various diseases, specifically the immune mechanism for COVID-19.Discussion : Vitamin D increases cellular innate immunity mainly by inducing antimicrobial peptides, which include cathelicidin, LL-37, 1,25-dihdroxyvitamin D and defensins, and also increase the secretion of hydrogen peroxide in monocyte cells. The administration of high-dose vitamin D of 10,000 IU / day for several weeks followed by 5000 IU / day is useful to prevent COVID-19, although the results still require further research. The sun exposure to activated vitamin D body is affected by skin color, using of clothing and sunscreen, and area of ??exposure. Sun exposure of one Minimum Erythemal Dose (MED) in adults can increase vitamin D concentrations equivalent to 10,000 - 25,000 IU vitamin D supplementation. Study on infants who were given exposure 3 times a week @ 5 minutes at 10:00 to 14:00, with exposure 50% of body surface area for 2 months, increased 25(OH)D of 8.9 ng/mL. Conclusion : Vitamin D which is activated by sun exposure is very useful as protection for various diseases including COVID-19, although its effectiveness still requires further research. Keywords : vitamin D, sun exposure, COVID-19.
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